Great Heat Stress Presentation

1. Heat Stress
John Newquist
June 2009

2. Severe Weather Fatalities
“…heat is by far the number one killer of all weather events…”
Courtesy National Weather Service Forecast Office

3. News
• CAL-OSHA labor officials
said Thursday, May 19,
2009 they have shut down
five more farm labor
contractors whose crews
were found laboring in triple-
digit heat with no shade, not
enough water and no
training in safety and
emergency response.

4. Fatalities
• 7/10/08
• A new, unacclimatized, 55
year old laborer collapsed
while working outdoors hand
excavating footings on a hot
and smoky day.
• Found to have a temperature
of 107*F, diagnosed with heat
stroke, admitted, but
progressed into multisystem
organ failure.
• The laborer died nine days
later on 20 Jul 08.

5. Fatalities
• On 7/10/08
• 37 year old male that was
loading boxes of grapes
• He was taken by
ambulance to Community
Hospital and was treated
for Heat Stroke with a
core body temperature of
108 degrees.
• He died on 07/31/08 at
3:25 p.m. from heat
stroke.

6. Fatalities
• 7/15/08
• A mechanic for the
employer suffered fatal
injuries from heat stroke
while working in the
service bay area of the
truck maintenance shop.

7. Fatalities
• 06/30/2008
• One worker unloading 40
pound sandbags to support the
installation of a 36" diameter
natural gas pipeline.
• Temperature was
approximately 110 degrees.
• The worker went down in the
late afternoon and was non-
responsive.
• The worker was air-evacuated
to a Medical Center and
passed away the following
morning at approximately
0930.

8. Fatalities
• 6/6/08
• Instructors conducting class in
fire fighting techniques.
Afternoon portion of class
included donning turnout gear
and SCBA for various
demonstrations and practical
application.
• Outside temperature high of 97
F.
• Victim collapsed during truck
water filling and was
transported to hospital, where
he was pronounced dead due
to heat exhaustion.

9. Risk Factors
• Age
• Weight
• Fitness
• Acclimatization
• Use of alcohol and
drugs
• Hypertension
• Clothing worn

10. Guidance
• OSHA has no specific heat illness
guidance. They would use the General
Duty Clause of the OSHA Act. (See next)
• NIOSH has guidance
• Cal-Osha has regulations that cover this
issue

11. Sample General Duty Clause
Violation
• Section 5(a)(1) of the Occupational Safety and Health Act of 1970: The employer did not furnish
employment and a place of employment which were free from recognized hazards that were
causing or likely to cause death or serious physical harm to employees in that: Employees were
exposed to excessive environmental heat while performing framing work on a single family
residential construction site. Employees were exposed to a heat index of approximately 102
degrees Fahrenheit, as reported on 08/03/2006, by the National Oceanic and Atmospheric
Administration weather station in Melbourne Florida. Such exposures may lead to the
development of serious heat induced illness such as heat exhaustion and/or heat stroke. a) For
employees performing framing and other related construction activities where the heat index is
approximately 102 degree Fahrenheit, the employer failed to asheat-load to which they may be
exposed and failed to develop and implement a heat stress program designed to protect
employees from that exposure. The estimated work-load for these employees puts them in the
moderate workload category as correlated with the guidelines established by the American
Conference of Governmental Industrial Hygienist (ACGIH) and the National Institute for
Occupational Safety and Health (NIOSH). Means of feasible abatement include but may not be
limited to: 1. Develop and implement a written heat stress program which includes, at a
minimum, the following items: a) Establish provisions for a work/rest regimen to reduce the work
exposure time to excessive environmental heat. b) A training program informing employees about
the effects, signs and symptoms and prevention of heat induced illness and to include specific
instructions and warnings concerning the effects of heat stress. c) An acclimation policy for new
employees to adjust to the working conditions. d) Develop and implement a pre-employment
medical questionnaire designed to determine employees' fitness to work in hot environments. e)
Provide protective covers or personal protective clothing to protect employees from the heat. f)
Provide ample supplies of cool drinking water.

12. Cal OSHA rules
• Provision of water.
• Employees shall have
access to potable
drinking water.
• Where it is not plumbed
or otherwise continuously
supplied, it shall be
provided in sufficient
quantity at the beginning
of the work shift to
provide one quart per
employee per hour for
drinking for the entire
shift.

13. CAL-OSHA rules
• Access to shade.
• Employees suffering from heat
illness or believing a
preventative recovery period is
needed, shall be provided
access to an area with shade
that is either open to the air or
provided with ventilation or
cooling for a period of no less
than five minutes.
• Such access to shade shall be
permitted at all times.

14. CAL-OSHA Rules
• Employee training. Training in the following topics shall be provided
to all supervisory and non-supervisory employees.
• The environmental and personal risk factors for heat illness;
• The employer's procedures for complying with the requirements of
this standard;
• The importance of frequent consumption of small quantities of
water, up to 4 cups per hour, when the work environment is hot and
employees are likely to be sweating more than usual in the
performance of their duties;
• The importance of acclimatization;
• The different types of heat illness and the common signs and
symptoms of heat illness;
• The importance to employees of immediately reporting to the
employer, directly or through the employee's supervisor, symptoms
or signs of heat illness in themselves, or in co-workers;

15. CAL-OSHA Rules
• Employee training continued
• The employer's procedures for responding to symptoms
of possible heat illness, including how emergency
medical services will be provided should they become
necessary;
• The employer's procedures for contacting emergency
medical services, and if necessary, for transporting
employees to a point where they can be reached by an
emergency medical service provider;
• The employer's procedures for ensuring that, in the
event of an emergency, clear and precise directions to
the work site can and will be provided as needed to
emergency responders.

16. CAL-OSHA rules
• Supervisor training.
• Prior to assignment to supervision of employees working in the heat,
training on the following topics shall be provided:
• The heat information required to be provided to employees
• The procedures the supervisor is to follow to implement the
applicable provisions in this section.
• The procedures the supervisor is to follow when an employee
exhibits symptoms consistent with possible heat illness, including
emergency response procedures.
• The employer's procedures shall be in writing and shall be made
available to employees and to representatives of Cal-Osha upon
request.

17. NIOSH Recommendations
• Schedule maintenance and repair jobs in hot
areas for cooler months.
• Schedule hot jobs for the cooler part of the day.
• Acclimatize workers by exposing them for
progressively longer periods to hot work
environments.
• Reduce the physical demands of workers.
• Use relief workers or assign extra workers for
physically demanding jobs.

18. NIOSH Recommendations
• Provide cool water or liquids to workers.
• Avoid drinks with caffeine, alcohol, or large amounts of sugar.
• Provide rest periods with water breaks.
• Provide cool areas for use during break periods.
• Monitor workers who are at risk of heat stress.
• Provide heat stress training that includes information about:
• Worker risk
• Prevention
• Symptoms
• The importance of monitoring yourself and coworkers for symptoms
• Treatment
• Personal protective equipment

19. NIOSH to Employees
• Wear light-colored, loose-fitting, breathable clothing such as cotton.
• Avoid non-breathing synthetic clothing.
• Gradually build up to heavy work.
• Schedule heavy work during the coolest parts of day.
• Take more breaks in extreme heat and humidity.
• Take breaks in the shade or a cool area when possible.
• Drink water frequently. Drink enough water that you never become
thirsty.
• Avoid drinks with caffeine, alcohol, and large amounts of sugar.
• Be aware that protective clothing or personal protective equipment
may increase the risk of heat stress.
• Monitor your physical condition and that of your coworkers.

20. Water Loss
 Normally, with light activity, your body loses 2 to
3 quarts of water daily.
 In a hot weather environment, you loose 6 to 8
quarts of sweat which is critical to your bodies
cooling.
 Your thirst mechanism is not sensitive enough to
be an accurate indicator of your body’s needs.
 Encourage workers to drink water-about a cup of
water every 15 to 20 minutes, even if they are
not thirsty. Avoid alcohol, caffeine and soft
drinks.

21. WBGTI
The Wet-Bulb Globe Temperature Index (WBGTI)
takes into account four variables: air temperature,
humidity, radiant heat and air movement. This
reading gives a more accurate measurement of heat
stress than any one reading alone.
Heat related illness includes: heat rash,
cramps, exhaustion and stroke. These
illnesses are a real danger to people not
accustomed to the stress of hot weather
exercise.

22. Heat Stress
Flag Colors
Black- Wet Bulb Globe Thermometer (WBGT) index of 90o or Above. Physical
Above 89 training and strenuous exercise must be suspended for all personnel. (excludes
operational commitment not for training purposes). A “20-minute work/ 10- minute
rest” cycle may be utilized, as well as employee rotation.
Red- WBGT index of 88 – 89.90. Strenuous exercise must be curtailed for all
88 – 89.9 personnel with less than 12 weeks training in hot weather.
Yellow- WBGT index of 85 – 87.9o. Strenuous exercise and activity
85 - 87.9 must be curtailed for new and unacclimatized personnel during the first 3
weeks of heat exposure. Outdoor classes in the sun must be avoided.
Green- WBGT index of 82 – 84.9o. Discretion is required in
82-84.9 planning heavy exercise for unacclimatized personnel. This is
a marginal heat stress limit for all personnel.
(numbers are Wet Bulb Globe
Temperature Index- not
temperature)
Wearing body armor or NBC protective uniforms adds approximately 10 points to measured WBGT. Limits of exposure should be adjusted accordingly.

23. Heat Stress Illnesses
Heat Rash
Causes- Heat rash normally happens most
often in hot, humid conditions, particularly wearing
heavy clothing and with excessive sweating. Fair
skinned individuals are more prone to develop heat
rash.
Symptoms: Interferes with sleep and results in decreased deficiency
and cumulative fatigue.
Treatment: Treated by keeping skin dry, use of cooled sleeping
quarters, calamine lotion.

24. Heat Stress Illnesses
Heat Cramps
Causes It occurs when large volumes of water are consumed without
adequate salt replacement.
Symptoms: Severe pain and cramps in legs and abdomen, fainting or
dizziness, weakness, profuse sweating and headaches.
Treatment: Increase fluid intake, increase salt intake, rest
and move to a cool place. Usually resolves after an electrolyte
beverage.

25. Heat Stress Illnesses
Heat Exhaustion
Causes Occurs when the heart and
vascular system do not respond properly
to high temperatures, and the
mechanisms our body uses to cool itself
fails
Symptoms: Headache, nausea, fatigue, dizziness, skin is cool and pale, pupils
become dilated. Victim is usually conscious but may faint, has a core temperature of over
102.
Treatment: Get to the shade, cool off, increase fluids, cold wet towels or ice, fan,
elevate legs above heart, loosen clothing, don’t give any liquids containing alcohol or
caffeine, may need IV. If condition worsens seek medical attention immediately. If left
untreated Heat Exhaustion can lead to HEATSTROKE.

26. Heat Stress Illnesses
Heat Stroke
Causes- Heat stroke is a medical emergency and a life threatening
condition. It is caused by the failure of the heat-regulating mechanisms of the
body, due to high heat and humidity.
Symptoms: Headache, nausea, dizziness, skin is red, dry and very hot
(sweating has ceased). Pulse is strong and rapid, small pupils, high fever 105.
May be disorientated, lose consciousness, possible convulsions.
Treatment: Remove to cooler location, loosen clothing, immerse in
cool water, wrap in wet sheets, cold compresses to the head, neck and groin.
Place ice pack behind neck - under arms
qSEEK MEDICAL ATTENTION IMMEDIATELY. DO NOT give medication to lower
fever, DO NOT use an alcohol rub.

27. • Underestimate the seriousness of heat
illness
• Give the victim medications to reduce
fever
• Give the victim liquids that contain alcohol
or caffeine
• Give anything by mouth if HEAT STROKE
is suspected

28. Heat Basics
• If muscles are being used for
physical labor, less blood is
available to flow to the skin
and release heat
• If body can’t dispose of excess
heat, it will store it. When this
happens the body’s core
temperature rises and the
heart rate increases.

29. Heat Basic
• Don’t use the feeling of thirst
as an indicator that you need
water.
• You can deplete as much as
30% of your body’s water
before you feel thirsty. Drink
plenty of water before, during
and after time spent in the
heat.
• Individuals vary in their
tolerance to heat stress
conditions

30. Prevention
• Spending time in air-
conditioned environments
• Increase nonalcoholic/
• Non-caffeinated fluid
intake
• Monitor urine output

31. More
• Persons working either
indoors or outdoors in
high temperatures should
take special precautions
including allowing 10 -14
days to acclimate to high
temperatures
• Salt tablets are not
recommended and may
be hazardous to many
people

32. Summary
• Develop a heat illness program
• Provide cooling or shaded area
• Plenty of water
• Training
• Treatment of heat illnesses
• Acclimatize workers

33. Questions?